Simplification and the Useful deployment of knowledge

We have written before when PS was an undergraduate student of speech pathology at Queens College CUNY, before going to Columbia University for her MA in Communications Disorders, before practicing in her first clinical year at a school in Manhattan. In our last phone call we talked about how clinical practice brings out the ability to deploy knowledge in a useful way. That reminds us of the Oscar Wilde quote about cynics, “A cynic is a man who knows the price of everything and the value of nothing.”

So how does applying the course-taught knowledge of a complex subject like speech language pathology make the student someone who can treat patients and deploy knowledge usefully? One insight might come from this e-mail PS wrote to JS just after she started working:

My first week primarily has consisted of learning about who my clients are. How they are at the present time, and how they were according to their files and medical history. I started treating on my second day. Each kiddo is unique and carries themselves differently throughout the day. I’ve hit a couple hurdles particularly with OT, PT factors such as distinguishing walkers from one another. I’ve gotta get the kiddos to speech somehow! Coordinating with them has been important. Team meetings have also been key to express concerns, status, and treatment plans for each kiddo.

Look at the purely practical concerns expressed, which are now gone after six months on the job. When we talked on the phone to continue our writing, PS mentioned to JS that she spent a lot of time simplifying the clinical wording so as to be able to explain what she was doing to patients and their families. We decided that this simplification issue needed more development, so PS writes again:

As a young professional, I am learning the value of simplifying my academic knowledge to layman terms. Why? Because aside, from working with other professionals such as nurses, occupational therapists, and physical therapists, I am working with and for concerned parents. Parents are expected to be lifetime supporters of their child in an ever shifting life of change … a change in schools, possibly moving, switching from one professional from another. They should know about the services their child receives. In fact it could be critical in determining what works, and what doesn’t. Therefore, it is my obligation to clearly explain to parents what my role is in their academic career, how I plan to go about my therapy, what my goals are, inquire what their goals are and build a level of trust, so that they can assure I know what I am doing. Not to mention, all of this has to be translated out of the professional speech-language pathology lexicon.

January and February are pretty big paperwork months, in the sense that we have turning five reports due for the clients that are transitioning from preschool to school aged programs. I developed really good rapport with one of my client’s parents, so much so we developed a friendship. I was required to write a turning five report for her son as his outside of school provider. His speech-language pathologist also wrote a report for him being that he receives services in school as well. I thoroughly explained my report to her and I asked if she sees his performance at speech therapy, at home too. She did. At the end of the discussion she asked if I could explain the turning five report she received from his school. She said, “because you know you guys have your vocabulary.” That made me question the value of these reports, if the parents don’t understand what skills their child has and the plan of treatment to acquire additional skills. Yes, professionals will get the message but as professionals we can fail by not explaining things to them thoroughly. The message is lost in translation when it reaches some parents.

The truth is, them not understanding the lexicon is our fault. I mean thinking back to the very speech pathology class I took, I remember being overwhelmed by influx of career-specific vocabulary. Countless classes, study sessions and sleepless nights, across 5 years, and I am finally well versed in this vocabulary. Concepts are built on repetition, experience and/or associations. If parents aren’t exposed to our lexicon, it is not fair that we expect them to understand it. Also, expecting them to ask questions should not be the expectation. We should have our bases covered. Some parents think their role is to have everything together, you know, have parenting all under control. That is not necessary the truth, but even thinking about my mom, her head was always on her shoulders, and she always perceived herself as though everything was under control. I don’t like to think of myself as a handful but I think my mom would disagree. As a speech-language pathologist, I cannot assume. I need to communicate in their language.

Simplification seems to be an important insight into the contextual deployment of useful knowledge in the workplace after learning it in the classroom. The test here is not connecting with the educated professor teaching the class or the peers in that class who have been exposed to the same material as have you the student. The test is in reaching people who know less and are depending on you the practitioner to share your knowledge in an impactful way. Simplification is then a key to being professional. It is something that can be most effectively taught in the work place as it requires the client, in this case the parent of the child who needs the explanation. It also requires the authenticity of real clients. Simulations are good, but there is nothing as good as the real-world application for this kind of learning.